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OB > 10. Menses > Flashcards

10. Menses Flashcards

1
Q

Menarche (def)

A

Onset of menstruation during puberty

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2
Q

When does menses begin? (4)

A
  • When the brain, ovaries and adrenal glands are mature

* When body fat is adequate

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3
Q

Perimenopause (def)

A

Period of time when ovarian function regresses (process, not event)

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4
Q

Climacteric (def)

A

A period of reproductive decline

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5
Q

Menopause (diagnostic def)

A

When a woman has stopped bleeding for 12 months – retrospective diagnosis.

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6
Q

Hormonal changes with menopause

A

Ovaries no longer producing estrogen, progesterone

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7
Q

Role of estrogen (menses) (6)

A
  • Control the development of the female secondary sex characteristics
  • Assists in the maturation of the ovarian follicles
  • Ensures that the endometrial mucosa is in a ready state
  • Estrogens also cause the uterus to increase in size and weight
  • Hormonal regulation
  • Increases libidinal feelings in humans
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8
Q

Secondary sex characteristics controlled by estrogen (4)

A

o Beast development
o Growth of body hair
o Widening of the hips
o Deposits of the tissue (fat) in the buttocks and mons pubis

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9
Q

Progesterone is secreted by ____

A

The corpus luteum

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10
Q

Progesterone is found in the greatest amounts during what phase of the menstrual cycle?

A

The luteal phase

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11
Q

Functions of progesterone (2)

A
  • Decreases uterine motility and contractility caused by estrogens
  • Causes the uterine endometrium to further increase its supply of life-sustaining components
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12
Q

Progesterone causes the uterine endometrium to further increase its supply of (5)

A
  • glycogen
  • arterial blood
  • secretory glands
  • amino acids
  • water
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13
Q

Prostaglandins (def)

A

Oxygenated fatty acids that are produced by the cells of the endometrium

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14
Q

Two types of prostaglandins discussed in class

A 
Prostaglandin E (PGE)
Prostaglandin F (PGF)
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15
Q

Characteristics of PGE (3)

A

PGE = Potent vasodilator
o Relaxes smooth muscle
o In sperm

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16
Q

Characteristics of PGF (2)

A

PGF = Potent vasoconstrictor

o Increases the contractility of muscles and arteries

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17
Q

Menstruation (def)

A

Periodic uterine bleeding that begins approximately 14 days after ovulation

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18
Q

Hypothalmic-pituitary (menstruation - def)

A

Negative feedback cycle that stimulates ovaries

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19
Q

Ovarian (menstruation - def)

A

Cyclic selection of a mature oocyte for ovulation

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20
Q

Endometrial (menstruation - def)

A

Cyclic proliferation and shedding of functional layer of the endometrium

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21
Q

3 concurrent cycles in menses:

A
  • Hypothalmic-pituitary
  • Ovarian
  • Endometrial
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22
Q

Hormones involved in the hypothalmic-pituitary cycle

A

GnRH (Gonadatropin Stimulating Hormone)

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23
Q

Phases of the ovarian cycle, and when each occurs (2)

A
  • Follicular Phase: Days 1-14

* Luteal phase: Days 15-28

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24
Q

What occurs during the follicular phase of the ovarian cycle?

A

One follicle is “selected” for ovulation

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25
Q

Follicular phase: Dominant hormone

A

Estrogen

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26
Q

What happens during ovulation? (Timing, hormones)

A

o Estrogen from ovarian follicles stimulates LH surge

o Occurs 34-36 hours after the LH surge begins (10-12 hours after LH peak)

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27
Q

What occurs during the luteal phase of the ovarian cycle?

A

What was the follicle becomes the corpus luteum

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28
Q

Luteal phase: Dominant hormone

A

Progesterone

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29
Q

Phases and timing of the endometrial cycle (4)

A
  • Menstrual phase (Days 1-5)
  • Proliferative Phase (Days 6-14)
  • Secretory phase (Days 15-26)
  • Ischemic phase (Days 26-28)
30
Q

Menstrual phase of endometrial cycle: What happens + hormonal reason

A

Shedding of the endometrium due to low estrogen levels

31
Q

Proliferative phase of endometrial cycle: What happens?

A
  • Period of rapid endometrial thickening

* Restoration of endometrial surface

32
Q

Secretory phase of the endometrial cycle: What occurs (and why)? (3)

A
  • Endometrium becomes edamatous and vascular (enables blood supply for implanted ovum)
  • Glycogen secreted (to prepare for fertilized ovum)
  • Progesterone increased from corpus luteum
33
Q

Ischemic phase of endometrial cycle: What happens (2)

A
  • Levels of estrogen and progesterone fall rapidly

* Corpus luteum degenerates

34
Q

Three other cyclic changes surrounding menstruation

A
  • Basal Body Temperature changes
  • Spinnbarkheit
  • Miittelschmirtz
35
Q

Changes in basal body temperature (2)

A

o Lowers prior to ovulation

o Elevates post-ovulation – Due to a rise in progesterone

36
Q

Spinnbarkheit (def)

A

Cervical mucus thin and stretchable (egg whites)

37
Q

Miittelschmirtz (def)

A

One-sided lower abdominal pain that coincides with ovulation

38
Q

Five menstrual cycle irregularities

A 
o	Amenorrhea
o	Oligomenorrhea
o	Menorrhagia
o	Metrorrhageia
o	Dysfunctional Uterine bleeding (DUB)
39
Q

Amenorrhea (def)

A

Lack of period

40
Q

Oligomenorrhea( def)

A

Light period

41
Q

Menorrhagia (def)

A

Excessive menstrual bleeding in duration or amount

42
Q

Metrorrhageia (def)

A

Spotting or hemorrhaging between normal cycles

43
Q

DUB (def)

3 characteristics

A

Dysfunctional Uterine Bleeding

  • Any bleeding that is irregular in amount, duration or timing and not related to normal menstrual bleeding. *Usually excessive.
  • Associated with ovulation.
44
Q

Primary amenorrhea (2)

A
  • Absence of menarche and secondary sex characteristics by age 14
  • Absence of menarche regardless of secondary sex characteristics by age 16
45
Q

Secondary amenorrhea

A

• A six month cessation of menses after a period of menstruation

46
Q

Causes of amenorrhea (7)

A
  • Pregnancy
  • Various diseases
  • Stress
  • Eating disorders
  • Strenuous exercise
  • Hormonal contraceptive
  • Menopause
47
Q

Dysmenorrhea (Def)

A

Painful menstruation

48
Q

Dysmenorrhea (prevalence)

A

Affects 50-80% of women

49
Q

Primary dysmenorrhea (def)

A

Associated with ovulatory cycles

50
Q

Secondary dysmenorrhea (def)

A

Acquired menstrual pain developed later in life ( >25 years old)

51
Q

Symptoms associated with primary dysmenorrhea (5)

A
  • Backache
  • Weakness, dizziness, syncope
  • Sweating
  • GI upset, anorexia, diarrhea, nausea, vomiting
  • Headache
52
Q

Primary dysmenorrhea: Treatment (2)

A

NSAIDs, fluids

53
Q

Cause of primary vs Secondary dysmenorrhea:

A

Primary dysmenorrhea: Associated with ovulatory cycles

Secondary dysmenorrhea: Associated with pelvic pathology

54
Q

Five types of pelvic pathology associated with secondary dysmenorrhea

A
  • Adenomyosis
  • Endometriosis
  • Pelvic Inflammatory Disease (PID)
  • Polyps
  • Fibroids
55
Q

Adenomyosis (def)

A

Endometrial tissue that grows into the muscular wall

56
Q

Endometriosis (def)

A

Endometrial lining grows outside of the uterus

57
Q

Premenstrual syndrome (def)

A

Physical and psychological symptoms beginning in the luteal phase of the menstrual cycle

58
Q

Premenstrual syndrome: Symptoms (6)

A
  • Water retention
  • Behavioral/emotional changes
  • Premenstrual cravings
  • Headache
  • Fatigue
  • Backache.
59
Q

Treatment for Premenstrual syndrome (3)

A
  • NSAIDs
  • Loop diuretic (Lasix) for bloating
  • SSRIs for mood stabilization
60
Q

Endometriosis: Characteristics (6)

A
  • Secondary amenorrhea
  • Dyspareunia – Painful intercourse
  • Abnormal uterine bleeding
  • Infertility
  • Pain during exercise because of adhesions
  • Bowel problems – endometrium can go into bowel
61
Q

Endometriosis treatment (2)

A

NSAIDs

Heat (to increase bloodflow to the pelvis)

62
Q

Endometriosis Diagnosis (2)

A

Ultrasound, clinical history

63
Q

Uterine polyps: Def

A

o Tumors on stalks arising from mucosa

64
Q

Where can uterine polyps occur? (2)

A
  • Endometrial

* Cervical

65
Q

What are the most common benign lesions of the cervix and endometrium occurring in reproductive years?

A

Uterine polyps

66
Q

What are fibroids

A

Benign, slow-growing tumors

67
Q

Fibroids: Types (5)

A
  • Intramural
  • Subserosal
  • Submucosal
  • Cervical
  • Pedunculated
68
Q

Which type of fibroid is least common & most symptomatic? Why?

A

SUBSEROSAL

• Affects the menstrual cycle

69
Q

Four causes of fibroids

A
  • Hormone replacement therapy (HRT)
  • Estrogen Replacement therapy (ERT)
  • Pregnancy
  • Oral contraceptive pills
70
Q

Treatment of fibroids (3)

A
  • NSAIDs for inflammation
  • Oral contraceptive pills (Keeps level stable)
  • Myomectomy – removal

OB (15 decks)

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